POST-THYROIDECTOMY HYPOCALCAEMIA: CLINICAL AND HISTOPATHOLOGICAL STUDY

Aim: To study the relation between post- thyroidectomy clinical hypocalcaemia and histopathological finding of parathyroid tissue. Methods: From Jan 2006 to June 2009; 50 cases of thyroidectomy was carried out. All surgical specimens were examined histopathologically. The cases that showed parathyroid tissue were recorded. Blood samples were collected for corrected serum (ionised) calcium on first postoperative day. Calcium (and vitamin D) treatment started from day one to all cases with low calcium levels (however clinical manifestatios of hypocalcimeamanifested or not). After two weeks, corrected calcium was measured. Patients with hypocalcaemia were followed up till 6 months postoperatively Results: The mean age of the patients was 34.7 years and 60% were female. Thirty cases were simple nodular goiter while 20 cases were Graves disease. Histopathological examination showed the presence of parathyroid tissue in 12 cases. Postoperative (ionised) calcium was within normal range in 45 patients while 5 patients had low (ionised) calcium level. Clinically, two patients presented with manifestations of hypocalcaemia. After two weeks of calcium treatment, corrected calcium level was back to normal except in one case that required long term calcium (and vitamin D) treatment. That case proved to have permanent hypocalcaemia as calcium level was still below normal after 6 months of surgery. Conclusions: The accidental removal of parathyroid tissue does not necessarily mean (temporary) or permanent hypocalcaemia. The incidence of (hypoparathyroidism in this study was lower than expected in relation to histopathological ly proven removed parathyroid gland)(early calcium and vitamin D treatment decreases the morbidity of temporary and permenant hypoparathyroidism)